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The canonical availability PPP / PFI: a private consortium designs, builds, finances and maintains a hospital, and a public authority pays a single, inflation-indexed unitary charge for keeping it available, with no demand risk. Not a merchant asset but a contracted government annuity: long, government-backed, indexed, reduced only by deductions for unavailability. Pick a real partnership below and trace it from construction through the payment mechanism to a working returns model.
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Drag the sliders to see what earns the money: the size of the hospital, the unitary charge per bed, and how available it is kept. Patient numbers play no part.
A hospital PPP / PFI is the canonical availability payment. A private consortium (a special-purpose vehicle) designs, builds, finances and maintains the hospital, and a public authority pays a single, inflation-indexed unitary charge over a long concession (25-30 years) covering the capital, the financing, the lifecycle (hard FM) and the facilities management (soft FM). The revenue does not depend on how many patients are treated; there is no demand risk. It is a contracted government annuity, paid in full so long as the hospital is available and performing, and reduced only by deductions for unavailability or performance failures. The return therefore turns on the beds, the charge per bed and the availability rather than clinical activity. Long, government-backed and inflation-linked, it is prized by pension and infrastructure funds for thin-but-very-stable equity returns, and most operational deals trade in the secondary market.
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See also the live hospital PFI simulation, which shows the wards lighting up and the availability vs FM economics in real time, and the Cash-flow & DCF model.